Temporomandibular disorders (TMDs) are the second most common musculoskeletal condition, negatively affecting both somatic and psychosocial function. Thus, the need for first-line conservative treatment like osteopathic manipulative treatment (OMT) and therapy (OMTh; manipulative care provided by foreign-trained osteopaths) is recognized.1,2 Researchers at the Medical University of Vienna conducted a randomized clinical trial to compare the effectiveness of OMTh with osteopathy in the cranial field in managing symptoms in patients with TMD.

Thirty-six women aged 18 to 55 years who experienced symptoms of TMD for more than 3 months were included in the study. Diagnosis was based on abnormal function, pain, tenderness, and joint sounds on mouth opening. Exclusion criteria included patients with previous operations or trauma to the region, patients with rheumatic or psychiatric disorders, and patients taking anti-inflammatory or muscle-relaxing medications. Participants were randomly assigned to receive either 30 minutes of OMTh or cranial osteopathy once per week for 5 weeks. The outcome measures included patient-reported pain intensity measured by a visual analog scale and the severity of TMD using the Helkimo Index. The patients also completed a questionnaire and a Short Form-36 Health Survey. These measures were taken at baseline and at the end of treatment. Data were analyzed using SPSS software (IBM), and intergroup comparisons were performed using a paired sample t test, the Wilcoxon signed-rank test, or the Mann-Whitney U test.

Statistically significant improvements were detected in all outcome measures, with no significant difference between the groups. Pain intensity improved 44% in the OMTh group and 48% in the cranial osteopathy group, and the calculation for all patients showed improvement after the treatments (paired sample t test: t35=6.7; P<.001). Additionally, the average value on the Helkimo Index decreased in both groups, with an improvement of 31% in the OMTh group and a 41% improvement in the cranial osteopathy group in TMD severity. The calculation for all patients showed an improvement after 5 treatments (Wilcoxon signed-rank test: z=−3.7; P<.001).

These findings demonstrate the benefit of OMTh in the management of musculoskeletal conditions. The findings also support the need for the osteopathic profession to continue funding and conducting large-scale randomized controlled trials that examine a variety of conditions to substantiate the use of manual manipulation for a variety of medical concerns.